Section 20 Precarious Teenage Adoptions: Resilience vs. Trauma

The Adoption and Children Act 2002 has considerable implications for practice. Targets for increasing the numbers of children leaving care for adoption will mean an increased emphasis on adoption for older children, for whom disruption rates have been high. Evidence of the precariousness of placements for older children and, especially, teenagers suggests that the overall objective of creating opportunities for increased stability and permanence of placement will not be easily achieved. Yet relatively little is known about teenagers in adoption, including knowledge about which kinds of young people succeed with which kinds of parents, as well as those whose placements do not endure. Nor is much known about which kinds of service provide most appropriate and helpful support for adopted teenagers. The Adoption Act requires comprehensive post adoption support services, which will include specialist therapeutically oriented services, and these services will have a crucial role to play. In this context, this paper reviews teenage adoptions, and pays particular attention to the ways in which therapeutically oriented post adoption services might make a significant contribution. This leads to a discussion of factors which underpin processes of ‘matching’ between young people and their adoptive parents.

Teenage adoption
Teenagers in adoption are not a homogeneous group. A small proportion, approximately 5% or 180 per year, of all adoptions involve children over 10 being adopted from care. Others reach adolescence following adoption as babies, or adoption later in childhood. Outcome studies for adoption show that babies placed for adoption tend to do well according to most key measures. Developmental outcomes are favorable compared with the general population and non-adopted children of similar socio-economic backgrounds to those of adoptive parents (Howe, 1997, 1998a). Children adopted as babies do have some areas of increased difficulties, for example, tendencies to have poor relationships with peers, compared with the general population. Overall, the increased levels of difficulty shown by children adopted as babies tend to lead to periods of difficulty for some children, rather than having globally raised levels of problems (Fergusson et al., 1995; Howe, 1998a). However, outcomes for any children placed later than six months increases the levels of difficulty. Children placed in mid and late childhood experience high rates of placement breakdown and globally raised levels of difficulty (Triseliotis, 2002; Lowe & Murch, 2002). Later adopted children have higher levels of emotional and behavioral difficulties, and are more likely to have either abusive, neglectful birth families or multiple placements in care, or both.

Age is a key risk factor for adoption (Triseliotis, 2002; Howe, 1997, 1998b), but Howe et al. (2001) remark, aptly, that age is a ‘proxy’ measure for the range of difficulties which beset late adopted children. The two groups of adopted adolescents most at risk therefore will be those who were adopted in childhood or as teenagers. Teenage adoptions are by this thinking the most precarious (Borland et al., 1991). Not only do they have to contend with the effects of difficult, disturbing, abusive and depriving birth families and the impact of repeated moves in care, but they have to undertake this whilst in the midst of the upheavals of the complex biopsycho-social changes of early adolescence. Mitigating this picture is the evidence that many teenage adoptions take place as a result of foster placements stabilizing over time (Triseliotis, 2002). Thus the meaning of adoption for these young people is to be found in the acknowledgement of this stability.

Clearly the psychological and emotional tasks would be quite different for these young people than those who move into a new adoptive placement during early adolescence. However, there is an absence of knowledge about how these different kinds of teenage adoptions work in practice (Rushton, 2003). Since breakdown rates for adolescents as a whole are somewhere between 15% and 50%, the need to know more about which adoptions work as well as those which do not is a very important consideration. As Triseliotis puts it, writing about both adoption and fostering:

The real challenge is in being able to recognize the 50% or so who can benefit from either adoption or long-term fostering without exposing children to unnecessary failures.

This challenge must be undertaken in the context of the new legislation, which can be briefly reviewed in order to contextualize the requirements for practice, with particular reference to post adoptive services.

The adoption ‘project’ and older children
The Adoption and Children Act 2002, which is most usefully seen as part of the government’s adoption ‘project’ (DFES, 2004), makes significant changes to the understanding of adoption and its place in child care legislation and policy. Driven by a pragmatic concern about the declining use of adoption, the variations in adoption practice and support for adopting families across the country, and delay in the processes of planning for placement, the Act’s implementation is fronted by the familiar use of ‘targets’, to increase the number of looked after children being placed for adoption and to reduce the time between the decision that adoption is in the child’s best interests and placing for adoption. However, the effect of the Act, and its supporting governmental initiatives, and particularly the introduction of comprehensive post adoption services, is to significantly alter the landscape of child care placement as well as redefining the nature of adoption itself.

With the 2002 Act, adoption gets relocated at the centre of the aim of stability and permanence for children. The Quality Protects agenda’s first objective is that of ‘ensuring that children are securely attached to carers capable of providing safe and effective care for the duration of childhood’ (Rushton & Dance, 2002, p. 50). The adoption project places adoption at the forefront of this objective. The aims of increasing the numbers of children placed for adoption and the requirement for comprehensive post adoption services acknowledges that if adoption is to play this leading role, then there also need to be service provisions which recognize the vulnerability of children in adopted homes. The SSI report on 34 local authorities, ‘Adopting Changes’ (DOH, 2000) concluded that current practice ‘was clearly not an acceptable way to support the placements of some very damaged and vulnerable children’ (p. 61). The shift which is heralded by this report is that adoption changes from being an ‘exit’ from care and the care system by which the child enters a ‘family’ functioning independently of the care system, to becoming a ‘placement’. The placement is intended to be enduring, ‘permanent’, but it is nevertheless a ‘placement’ and the child’s history of loss and separation is to this extent recognized as bringing difficulty which may, and often does, require wide ranging supportive services. The comprehensive post adoption services as envisioned should provide from October 2003 a range of financial, furnishing, building as well as therapeutic and educational supports for adoptive children and their adopting parents.

Not surprisingly, the adoption project has generated a wide reaching evaluative and research agenda. The DFES has recently commissioned research which aims to evaluate the impact of increasing the numbers of children adopted, and in legally secure permanent placements,4 whether and how delays in the process are reduced, whether new support services are more consistently applied across the country and whether these increase access. These research initiatives aim to explore and analyze changing trends in adoption, as well as evaluating innovative practice. In particular there is a desire to know how the new measures affect disruptions, the age and background of children placed for adoption, the preparation of adopters and children and the matching process. There is the need to know whether multidisciplinary working is improved and whether adoptive children and families obtain better access to psychological and therapeutic services, and how these impact on adoption for ‘harder to place’ children.

Making use of therapeutic approaches to adoption
The increased use of adoption for older children, including teenage adoptions, will require a central role for post adoptive services, and therapeutic and specialist services will have important roles. These are required primarily to work with families and children who experience difficulty in placement, but they are also involved in preparation of children for placement (Fahlberg, 1991) and, indirectly, in training adoptive carers and matching carer and child. Rushton and Dance (2002) show the contradictory positions of therapeutic thinking and practice in adoption to date. On the one hand, they have been difficult to access, inflexibly structured and not responsive to the needs of permanency planning. An extremely inflexible position involved the traditional practice of therapeutic agencies not becoming involved with looked after children who were in transition, and therapeutic help was often offered only when a child was securely placed. On the other hand, Rushton and Dance show that therapeutic approaches, influenced by psychoanalytic and attachment theories, have had an innovative part to play in the development of adoptive services. Both attachment and psychoanalytic approaches to adoption are predicated on looked after and adopted children having essentially difficult and traumatic early experiences of separation, and loss. Subsequent experiences of inadequate parenting in birth families, including abusive experiences, and, often, multiple placements, serve to exacerbate these disruptions to the need for continuity of parenting with ‘good enough’ parental figures. The view that looked after children tend to have emotional, behavioral, educational and relational difficulties greater than their non-looked after peers is supported by a wide range of sources (Parker, 1999; Rushton & Dance, 2002; Lowe & Murch, 2002) and the focus of recent policy, following Quality Protects, has emphasized the need to consider the mental health needs of looked after children (Walker, 2002).

These debates tend towards the development of two dichotomous positions, best summarized as proponents of ‘resilience’ and ‘trauma’ respectively. The idea of resilience is an important one, though it is often used to describe both a defensive denial of painful experience as well as the capacity to digest, metabolize and reflect realistically on painful experience while maintaining hopefulness and emotional engagement. Resilience means more than ‘bouncing back from adversity’ (SCIE, 2003). Both psychoanalytic and attachment theories posit a similar precondition for resilience in childhood, namely the availability of a reliable enduring relationship. Specifically, psychoanalytic and attachment based approaches have the potential to assess the child’s needs and the meaning of the child’s experiences in placement, the meaning of placement difficulties in the context of the carer/child relationship and the factors likely to pertain in matching child and carer. Both theoretical approaches, it will be argued, have complementary contributions to make.
- Briggs, Stephen & Liz Webb; Matching and mismatching in teenage adoptions: implications of the adoption act for practice; Journal of Social Work Practice; Jul 2004; Vol. 18; Issue 2.The article above contains foundational information. Articles below contain optional updates.

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Reflection Exercise #6The preceding section contained information
about an overview and therapeutic approaches in teenage adoption. Write
three case study examples regarding how you might use the content of this section
in your practice.

Online Continuing Education QUESTION 20 What is the first objective of the Quality Protects agenda? Record the letter of the correct answer
the CEU Answer
Booklet.